Kentucky Enacts Sweeping New Heroin Law, But Needle Exchange Program Still Has Some Lawmakers Worried

August 11, 2015
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Novus Medical Detox Center

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Kentucky lawmakers have passed sweeping new legislation aimed squarely at the state's never-ending war with drug addiction, drug crime and drug overdose deaths.

Nicknamed the "heroin law" by the media, it's designed to increase funding for treatment programs, tougher penalties for drug dealers, a "Good Samaritan" provision to protect addicts who report an overdose, and a needle exchange program to reduce communicable disease infections like hepatitis and AIDS.

The contentious Senate Bill SB 192 is the most recent of several programs passed this year to tackle the heroin and opioid addiction problems that plague Kentucky. The Democrats wanted the needle exchange program and more treatment money and facilities, while the Republicans wanted tougher penalties for drug dealers and were not in favor of the needle exchange.

Talks had broken down last year on the two approaches. But after weeks of wrangling earlier this year, a compromise bill was finally passed during the late-night closing hours of the final day of the General Assembly, and was promptly signed into law by Kentucky Gov. Steve Beshear.

Attorney General Jack Conway told a reporter, "I didn't care if the bill was a House bill, I didn't care if it was a Senate bill. I didn't care if it was a Republican bill, I didn't care if it was a Democratic bill. But we needed these additional tools to deal with this epidemic."

Decades of crime and tragedy

After two decades battling an OxyContin epidemic that seemed it would never end, Kentucky finally obtained a few brief moments of relief when Purdue Pharma reformulated the time-release pain killers a few years ago. The new Oxy pills were more difficult to abuse.

Shortly after, another popular opioid painkiller, Opana, was similarly reformulated.

With both these widely-abused drugs now harder to crush and snort or inject, there seemed to be a slow-down in the crime and death rates.

The relief was mostly illusion.

As street prices on illicit OxyContin and Opana and other pain pills soared, heroin began pouring into the state, mostly from Mexico. At one-fifth to one-tenth the price of Oxycodone, almost overnight heroin became the drug of choice.

Today, heroin continues to expand and tighten its deadly grip across the state.

"Gutted and rewritten" bill goes farther than ever

According to media reports, the state's House Judiciary Committee finally approved a "gutted and rewritten" SB 192 - but most agree it goes a long way in the battle against heroin addiction and deaths - farther than the drug-troubled state has ever gone before.

The bill originally addressed inmate health care. But after months of wrangling and discussion, Bill 192 became 35 pages of laws governing treatment for heroin addiction and trafficking penalties.

Penalties

House Republicans got some of their demands for harsher penalties. Drug dealers caught with more than two grams of heroin will indeed face much tougher penalties. Under previous state law, trafficking would fetch one to five years. The new bill sends traffickers to prison for five to 10 years for two to 100 grams and 10 to 20 years for more than 100 grams.

House Democrats wanted to leave penalties the same for people caught with less than two grams. Such low-level dealers are not serious commercial dealers, but users trying to feed their habit. Rather than heavy penalties, they would be encouraged to seek treatment through the state's drug courts.

Treatment

The new bill provides more money for substance abuse programs which in Kentucky have long been in short supply.

Kimberly Wright, co-founder of Kentucky Parents Against Heroin, told local news that it's been particularly bad for kids and younger adults. "We've got kids coming out of the woodwork," she said. "They don't want to do heroin. They want help. The problem is, we don't have enough treatment, we don't have enough detox, we don't have enough beds."

Bill 192 also provides treatment centers with funding for expansion as well as increased Medicare coverage.

Rep. John Tilley, a Democrat, called the bill a "comprehensive piece of legislation that will save lives." Tilley told local media that the bill allows heroin users to exchange dirty needles for clean ones at the state's regional health departments, but only if local jurisdiction approves. "It eliminates barriers to treatment, and it does so much more," Tilley said.

Good Samaritan

The law's new "Good Samaritan" provision gives immunity to people who report an overdose. Heroin addicts often don't report overdoses they witness for fear of being arrested or harassed by law enforcement.

Similar to those in other jurisdictions, Kentucky's Good Samaritan provision protects users from prosecution when calling 911 to report that an overdose, provided they give their own name (and address if they have one).

Naloxone

The bill also makes the overdose-reversal drug naloxone, widely known by its trade name Narcan, more widely available - but a prescription is required. The new law allows pharmacists to prescribe the drug.

Needle exchanges

Under the new bill, local governments now have the option to legally create and manage needle exchanges under the department of health, to recover used syringes and pass out new ones to addicts.

This was the most contentious section of the bill, pitting the Democrats against the Republicans. Critics say that handing out clean needles encourages drug use. But proponents say sharing needles has resulted in a 1600-percent increase in hepatitis infections since the heroin epidemic took off a few years ago. Providing clean needles could significantly reduce this.

Tilley said the explosion of HIV cases among heroin users in neighboring Indiana is at the same rate of growth as the HIV epidemic raging in sub-Saharan Africa. It was suggested that the increase in HIV infections could be the same in Kentucky, but no statistics were provided.

Gov. Beshear said that although needle exchanges were the most controversial part of the bill, they were "too important to leave out. I encourage every community to look at the possibility of opening up needle exchanges. I think it's a public health issue. It also allows us to establish contact with a lot of people that are in trouble."

However, as recently as last month, Senate President Robert Stivers asked for an opinion from Attorney General Jack Conway on whether Louisville's needle exchange program "overreaches the authority granted" in the new bill. Stivers said in a statement that "the exchange provision was part of a compromise, and it was our expectation that it would be an actual exchange, not a new distribution point for needles."

Dr. Sarah Moyer, interim director of the Louisville Metro Department of Public Health and Wellness, said a one-to-one exchange implies there is no lack of syringes and no needle sharing occurs. "We know that is not the case as evident from the HIV outbreak in Indiana," Moyer said. "We believe the Louisville Metro Syringe Exchange Program is in compliance with SB 192 as well as with the guidelines established by the Kentucky Department for Public Health."

Stivers told reporters that whether or not the department changes its needle exchange policy, "the definition of a needle exchange needs to be codified in the law during the 2016 legislative session."

"A needle giveaway? That was never the context in which the program was discussed," Stivers said. "The clear language 'needle exchange' means there is a swap. The impetus of this was to get the dirty needles out of the system. If they do not change their processes, I feel that we will clarify that in the next session."

Battle lines are drawn

It appears Kentucky is serious about combating the state's drug epidemic. SB 192 lays out a comprehensive array of battle lines that, along with earlier bills, show that lawmakers from both sides of the house are overcoming their political ideologies to create an effective unified front.

Here at Novus Medical Detox Center, we're equally committed to doing everything we can to help individuals get their lives back. For help with substance abuse of any kind, don't hesitate to call. We're here to help.